Cerebral Palsy is a non-progressive neurological condition that affects voluntary movement and can make it challenging for your child to get around. The good news is that Cerebral Palsy treatment has advanced more than ever and can significantly enhance your child’s motor abilities. There are several subtypes of Cerebral Palsy, and knowing how to tell among them is crucial for a correct early diagnosis. Here, we offer a brief guide to the characteristics of Cerebral Palsy in its various forms so that you know what to watch out for in your growing child.
Understanding Cerebral Palsy
Cerebral Palsy is a group of non-progressive neurological disorders that affect movement, muscle tone, coordination, and gait. It occurs due to damage to the brain on account of an injury or infection before, during, or shortly after birth. Cerebral Palsy affects gait, balance, gross and fine motor skills, and coordination, and may also lead to problems with vision and cognition. Early intervention and treatment can improve the child’s outcomes and may even fully cure certain motor symptoms.
Characteristics of Cerebral Palsy
Cerebral Palsy characteristics can be spotted as early as a few months or as late as 4 years of age. Some patients have it mildly and may learn to walk on their own with the help of a cane, while others have more severe cases and may require wheelchair assistance all their lives.
The chief distinguishing feature of Cerebral Palsy is impaired gait and movement as a result of damage to the brain. The location of the impaired function and the impact on muscle tone will differ from person to person. In general, the first sign that your children may have Cerebral Palsy is missing key developmental milestones, such as rolling over or crawling.
There are six types of Cerebral Palsy, each with its own characteristics, that your child may be diagnosed with. We break down each of these as follows.
Spastic Cerebral Palsy
This is the most common type of Cerebral Palsy and accounts for about 70% of all cases. It occurs due to damage in the brain’s motor cortex. Spastic Cerebral Palsy characteristics include:
- Trouble lifting one’s head as a baby
- Tightened muscles due to increased muscle tone
- Rigidity and stiffness in the limbs
- Exaggerated movements
- Difficulties with breathing, speaking, and swallowing
- Hoarse voice
- Scoliosis (dislocation of the spine)
- Limb and joint deformities
- Difficulty with fine motor skills
- Scissored gait
Dystonic Cerebral Palsy
This is a subtype that is characterized by uncontrollable movements and muscle contractions that are often painful. It occurs due to damage in the basal ganglia, which controls motor function and learning. Depending on which body parts are affected, Dystonic Cerebral Palsy can be classified into:
- Focal dystonia, which affects just one side of the body
- Generalized dystonia, which affects the entire body or most of it
- Hemidystonia, which affects an arm and the corresponding leg
- Cervical dystonia, which affects the shoulders, head, and neck
- Oromandibular dystonia, which affects the mouth, tongue, and jaw
The main Dystonic Cerebral Palsy characteristics include:
- Movements that alternate between fast and slow
- Involuntary movements that get worse if the child tries to control them
- Gait problems
- Painful movements and contractions
- Speech and swallowing difficulties
- Foot cramps
- Uncontrollable blinking
- Fatigue due to uncontrollable movements
Hypotonic Cerebral Palsy
This is a rare variant of Cerebral Palsy and also accounts for about 2.6% of cases. It occurs due to damage to the cerebellum. Its key symptoms include:
- Low muscle tone
- Floppy limbs
- Unusually flexible joints and ligaments
- Excess muscle flexibility
- Poor trunk stability
- Unusually wide gait
- Poor head control
- Slow reflexes
- Chewing and swallowing difficulties
- Making grunting, breathy noises
- Learning disabilities
- Cognitive delays
Ataxic Cerebral Palsy
This is a non-spastic variation of Cerebral Palsy that accounts for about 5% of all cases. It occurs due to damage to the cerebellum. Its chief characteristics include:
- Low muscle tone
- Involuntary movements that can be slow, fast, rhythmic, repetitive, or non-repetitive
- Exaggerated movements when the patient attempts to move voluntarily
- Poor balance and posture
- Unsteady gait
- Poor control over eye movements and depth perception
- Poor hand-eye coordination
- Impaired fine motor skills like handwriting
Athetoid Cerebral Palsy
This is a subtype of Cerebral Palsy in which the child’s muscles fluctuate between hypotonia and hypertonia. It occurs due to damage to the basal ganglia or the cerebellum or both. Its main features include:
- Involuntary movements in the legs, arms, and hands
- Slow writhing movements that are repetitive and rhythmic
- Jerky, shaky movements
- Twisting of the torso
- Abnormal posture
- Grimacing or drooling
- Poor balance and coordination
Mixed Cerebral Palsy
This is a subtype in which the patient experiences symptoms of more than one of the above types of Cerebral Palsy. It occurs due to damage to more than one part of the brain, including the motor cortex, cerebellum, pyramidal tracts, or basal ganglia. The most common variant is Spastic-Dyskinetic Cerebral Palsy. Mixed Cerebral Palsy accounts for about 15.4% of all Cerebral Palsy cases. The characteristics will vary depending on where the brain damage occurred and how severe it is.
Treatment for Cerebral Palsy
Regardless of what characteristics of Cerebral Palsy a child may have, tailored rehabilitation is their best bet for symptom management and daily independence. The healthcare team will tailor each element of the program to the child’s specific needs and modify the treatment goals as the child shows progress. The chief objective is to help the child transition into adulthood as painlessly and independently as possible.
In general, a treatment program for Cerebral Palsy comprises:
- Physiotherapy: This focuses on improving strength, flexibility, and coordination while easing pain. For patients with hypertonia, physiotherapy focuses on reducing the muscle contractures from the unusual tightness. For patients with hypotonia, the focus is on improving muscle strength through resistance training to improve control over floppy limbs.
- Occupational Therapy: The aim of Occupational Therapy is to help children pick up activities of daily living, either on their own or with the help of assistive devices. For instance, the therapist can teach the child how to button clothes or use a fork to eat.
- Mobility aids: These help the child move around as independently as possible. A brace, for instance, can correct bone and joint deformities when applied early. For children with more severe Cerebral Palsy characteristics, a wheelchair can help them get around without trouble.
- Speech Therapy: This helps to train the muscles of the mouth, jaw, and tongue for easy and safe speaking and swallowing.
- Cognitive Therapy: One of the common characteristics of Cerebral Palsy is cognitive delays. Special therapists can help children overcome these through various mental exercises that build memory, attention span, and learning ability.
- Massage Therapy: Massage helps to counteract the motor characteristics of Cerebral Palsy by easing muscle tension and helping the limbs relax. It also serves to mentally relax the child and improve their overall wellbeing.
- Recreational Therapy: All children love to play, which is why recreational therapists focus on sessions that incorporate various types of games and activities that teach daily skills while being fun.
- Stem Cell Therapy: This is a revolutionary form of treatment in which the patient’s healthy cells are used to replace the damaged ones in the brain to reverse the symptoms of Cerebral Palsy. Studies have shown significant improvement in Cerebral Palsy characteristics with regular Stem Cell Therapy sessions, and it may even potentially be a cure someday.
What characteristics do all individuals with Cerebral Palsy have?
Some of the classic characteristics of Cerebral Palsy include tremors, jerky movements, hypertonia/hypotonia, poor balance and coordination, difficulty swallowing, and vision problems.
What characteristic is common to all individuals with Cerebral Palsy?
No two cases of Cerebral Palsy are exactly alike. However, all individuals with Cerebral Palsy will have some degree of motor impairment as well as some form of difficulty with posture and coordination.
What are three early signs of Cerebral Palsy?
Some of the early signs of Cerebral Palsy include delays in hitting developmental milestones, exaggerated movements, and unusually stiff or floppy limbs.
What are the different classifications of Cerebral Palsy?
The various subtypes of Cerebral Palsy include Spastic, Dystonic, Athetoid, Hypotonic, Ataxic, and Mixed.
How would you describe the gait of Cerebral Palsy?
Patients with Cerebral Palsy tend to have gait problems including crouched gait, scissored gait, unusually wide gait, or toe walking.
What does mild Cerebral Palsy look like?
Mild Cerebral Palsy characteristics could include stiffness in one limb, walking with one foot dragging, or difficulty with fine motor skills. Many symptoms may not even be noticeable until the child is around four or five years old.
How do you diagnose Cerebral Palsy?
There is no one test to detect Cerebral Palsy. Doctors will typically assess the child’s reflexes and motor control in a clinical setting and then conduct tests such as an MRI, a cranial ultrasound, or a CT scan to check for brain damage.
When do signs of Cerebral Palsy appear
The signs of Cerebral Palsy can appear within the first few months of a child’s life, and usually present as delays in hitting milestones like rolling over or crawling. However, in some mild cases, parents may not detect any symptoms until the child is a toddler.
In conclusion, Cerebral Palsy characteristics are a clue to the exact subtype of CP the child has, which is why parents should carefully observe their child’s behavior from an early age. It is also important to remember that no two cases of Cerebral Palsy look exactly alike. While there can be several less serious causes behind your child’s symptoms, your intuition as a parent is what matters the most. So if you feel that your child may have Cerebral Palsy, make an appointment with your doctor and get a diagnosis as soon as possible.